Systematic Review of Measures of Impairment and Activity Limitation for Person with Upper Limb Trauma and Amputation.

OBJECTIVE: Study purposes were to 1) identify outcome measures used in studies of persons with traumatic upper limb injury and/or amputation and 2) evaluate focus, content and psychometric properties of each measure. DATA SOURCES: Searches of PubMed and CINAHL for terms including upper extremity, function, activities of daily living, outcome assessment, amputation and traumatic injuries. STUDY SELECTION: Included articles had a sample of ≥10 adults with limb trauma or amputation, and were in English. Measures containing a majority of items assessing impairment of body function or activity limitation were eligible. DATA EXTRACTION: Two hundred sixty papers containing 55 measures were included. Data on internal consistency; test-retest, inter-rater, and intra-rater reliability; content, structural, construct, concurrent, and predictive validity; responsiveness; and floor/ceiling effects were extracted and confirmed by a second investigator. DATA SYNTHESISRESULTS: The mostly highly rated performance measures included 2 amputation specific measures: Activities Measure for Upper Limb Amputees, University of New Brunswick Test of Prosthetic Skill and Spontaneity, and 2 non-amputation specific measures: Box and Block Test, and modified Jebsen-Taylor Hand Function test light and heavy cans tests. Most highly rated self-report measures were DASH, Patient Rated Wrist Evaluation, QuickDASH and Hand Assessment Tool (HAT), International Osteoporosis Foundation Quality of Life Questionnaire and Patient Rated Wrist Evaluation Functional Recovery subscale. None were amputation specific. CONCLUSION: Few performance measures were recommended for patients with limb trauma and amputation. All top rated self-report measures were suitable for use in both groups. These results will inform choice of outcome measures for these patients.